title: Prospective evaluation in 123 patients of strain ratio as provided by quantitative elastosonography and multiparametric ultrasound evaluation (ultrasound score) for the characterisation of thyroid nodules.
abstract: OBJECTIVE
  This study was done to compare quantitative elastosonography and ultrasound analysis in the characterisation of thyroid nodules.
  
  
  METHODS
  From July 2009 to September 2011, 123 patients with 147 thyroid nodules were included in our study. All patients enrolled had to undergo thyroidectomy because of nodular thyroid disease (goitre or nodules). After preliminary examination with conventional ultrasound (US) and colour Doppler US, the patients were examined with elastosonography, using high-level equipment (Toshiba Aplio XG) and quantitative software (Elasto-Q). Each lesion was characterised using an US score (echogenicity, borders, microcalcifications and colour Doppler pattern), and then by elastosonographic strain ratio. Each patient subsequently underwent thyroidectomy. Histological results were used as the gold standard.
  
  
  RESULTS
  Histological examination demonstrated 89 benign and 58 malignant lesions. On average, the strain ratio value was 2.84±2.69 (range, 0.05-14.5; p=0.001). Sensitivity and specificity of the US score were about 56% and 72%, respectively, whereas those of the strain ratio were 93% and 89%, using a cut-off of 2 obtained with receiver operating characteristic (ROC) curve analysis. Elastosonography was more accurate than US and colour Doppler US in characterising thyroid nodules (p=0.002).
  
  
  CONCLUSIONS
  Quantitative elastosonography is a useful diagnostic tool in the evaluation of thyroid lesions, and can be used to limit fine-needle aspiration cytology and improve the selection of patients for thyroidectomy.
authors.affiliation: Dipartimento di Scienze Radiologiche, Oncologiche ed Anatomopatologiche, Sapienza Università di Roma, Viale del Policlinico 155, 00161, Rome, Italy.
authors.forename: Vito
authors.initials: V
authors.lastname: Cantisani
authors.forename: Vito
authors.initials: V
authors.lastname: D'Andrea
authors.forename: Ester
authors.initials: E
authors.lastname: Mancuso
authors.forename: Elena
authors.initials: E
authors.lastname: Maggini
authors.forename: Mattia
authors.initials: M
authors.lastname: Di Segni
authors.forename: Matteo
authors.initials: M
authors.lastname: Olive
authors.forename: Pietro
authors.initials: P
authors.lastname: Lodise
authors.forename: Silvio
authors.initials: S
authors.lastname: Palermo
authors.forename: Sergio
authors.initials: S
authors.lastname: De Antoni
authors.forename: Adriano
authors.initials: A
authors.lastname: Redler
authors.forename: Gregorio
authors.initials: G
authors.lastname: Patrizi
authors.forename: Andrea
authors.initials: A
authors.lastname: Porfiri
authors.forename: Giovanna
authors.initials: G
authors.lastname: Panzironi
authors.forename: Paolo
authors.initials: P
authors.lastname: Ricci
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D016606:Thyroid Nodule / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D013965:Thyroidectomy; D018615:Ultrasonography, Doppler, Color